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Delirium referral — DGM MCQ

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ModerateDeliriumDelirium referralDGM

An 84-year-old man has persistent delirium despite correction of infection, pain and retention. He has fluctuating alertness, hallucinations and unsafe swallowing. The ward team is unsure about capacity and discharge planning. Current medicines include ramipril and metformin. What is the most appropriate referral?

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Correct answer: D — Geriatric medicine or liaison psychiatry review

Persistent complex delirium with safety, capacity and discharge issues warrants specialist review, often geriatric medicine or liaison psychiatry depending on local pathways. Dermatology, cataract and sleep clinic referrals do not address the acute syndrome, and waiting for outpatient review risks harm. Delirium care often needs multidisciplinary input when it does not resolve quickly.

Reference: NICE CG103; BGS delirium guidance